Ah, Fall: the days are getting shorter, the weather is cooling down, and the kids are a few months into school. And while we’re setting up our Halloween decorations, buying pumpkin-spice-everything, and cozying up the house, it’s important to be aware of a common virus kids can get when they’re packed like sardines in a classroom: Hand, Foot, and Mouth Disease.
Hand, Foot, and Mouth Disease (HFMD) is a benign, low-stakes disease that is highly contagious, but nothing to panic about. It will keep your child out of school for a few days, but it will likely pass on its own without much treatment. Here are some highlights about HFMD from AFMC’s Chief Medical Officer, Dr. Chad Rodgers.
What is Hand-Foot-and-Mouth Disease, and how does it spread?
HFMD is a virus that infects the gastrointestinal tract from the mouth to the anus. It can cause painful sores and blisters around the anus, hands, and feet, and around and inside the mouth. Sores can occasionally appear on the inner thigh as well.
“Because these sores make it hurt to swallow, a child with HFMD will drool a lot,” Dr. Rodgers says. “The virus can still live in that bit of saliva and cause the disease to spread.”
The disease gets its name from the way the virus spreads: young children tend to put their hands and feet in their mouths because of the discomfort. When those children touch toys, pacifiers, or sippy cups, the virus spreads to other children who pick up those items.
“The virus can also live in a child’s stool, so it’s important for parents and caregivers who change diapers to wash their hands thoroughly to kill it,” Dr. Rodgers adds.
Why does HFMD spread more quickly during late summer and early fall?
Just like we saw with COVID, as more people spend time indoors in close proximity with one another, the virus has less distance to travel and can spread more easily.
However, it’s important to know that HFMD is a common disease children contract from just doing what children do:
“From eating to playing, it’s a common part of childhood that they get exposed to viruses like this and share them with others,” Dr. Rodgers says. “Most children get better after contracting HFMD, and this contributes to building a healthy immune system.”
What symptoms should doctors watch for in children with HFMD?
“Typically, with HFMD, you’re going to see a rash,” Dr. Rodgers explains. “The child will also develop a fever and not feed well. Then, the blisters form.”
HFMD has a distinct pattern of blisters in areas of the body distinguished by its name. This helps doctors recognize it over chickenpox or strep that can appear on the trunk and be redder and rougher to the touch than HFMD blisters. 
Doctors who diagnose HFMD should advise parents and caregivers to keep children drinking fluids like Pedialyte or other drinks with electrolytes, so they don’t become dehydrated. Like most viruses, HFMD lasts a few days and then resolves on its own. In very rare cases, children with severe HFMD will not drink fluids at all and may need to receive IV fluids at the hospital.
What can parents and caregivers do to reduce the spread of HFMD?
Dr. Rodgers recommends one simple practice that is key to reducing the spread of viruses like HFMD: good handwashing, good handwashing, good handwashing.
Cleaning surfaces where children eat, sit, have their diapers changed, play (and drool) will also help prevent the spread.
“There are no immunizations for HFMD because it does not commonly cause significant long-term illnesses or health consequences,” Dr. Rodgers adds. “It is a part of childhood and helps build a healthy immune system.”
When can children return to school or daycare after contracting HFMD?
Children can return to school if they are:
- Fever-free for 24 hours without taking fever-reducing medicines,
- Feeling better (not fussy or complaining of discomfort/pain),
- Drinking fluids well without pain when swallowing, and
- Free of open blisters or lesions that can shed the virus.
What else should doctors know about HFMD?
Other than the basics we’ve covered here, Dr. Rodgers only has a brief reminder for doctors about HFMD:
“It’s certainly no fun and causes a lot of discomfort for children. It can be inconvenient for parents who may have to miss time at work to care for a sick child, especially if the child is severely dehydrated and requires a hospital stay. Some adults can contract HFMD, too, if they’ve never had it before. But in the end, it’s important to remember that, while miserable, HFMD is nothing to worry about. Most people will recover on their own with no severe health consequences.”
Where can parents find more information about HFMD?
There are lots of great, trusted sources of information out there for parents on HFMD:
- Hand, Foot, Mouth Disease – What is It?
- About Hand, Foot, And Mouth Disease
- Peds Doc Talk: Hand, Foot, and Mouth Disease: Symptoms and Care
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